Kardiol Pol. 2026 May 28. doi: 10.33963/v.phj.112912. Online ahead of print.
ABSTRACT
BACKGROUND: Malignant cardiac tamponade is a life-threatening manifestation of advanced malignancy. Most studies combine patients with malignant pericardial effusion, limiting insights specific to cardiac tamponade.
AIMS: This study aimed to characterize the clinical profile, outcomes, and predictors of mortality in patients undergoing pericardiocentesis for malignant cardiac tamponade.
METHODS: We performed a retrospective observational study of consecutive patients who underwent therapeutic pericardiocentesis for malignant cardiac tamponade between 2012 and 2024 at a tertiary referral center. Clinical characteristics and outcomes were assessed. Survival was estimated using Kaplan-Meier analysis, and predictors of mortality were evaluated using Cox proportional hazards models.
RESULTS: Among 613 cases of cardiac tamponade unrelated to cardiac surgery, 180 patients met the inclusion criteria. Dyspnea was the predominant symptom (99.4%). Lung cancer was the most common malignancy (53.9%), and metastatic disease was present in 78.8%. In-hospital mortality was 12.8%, and 30-day mortality was 25.5%. Pericardial fluid cytology was positive in 47.8%. Recurrent tamponade occurred in 11.9% of patients, with a median time to recurrence of 50 days. During follow-up, 88.7% died. Median survival was 144.5 days (95% confidence interval, 28.3-477.9), and the estimated 1-year mortality was 66.5%. Lung cancer was associated with higher mortality in multivariable analysis (hazard ratio, 1.50; P = 0.017).
CONCLUSIONS: Malignant cardiac tamponade is a late manifestation of advanced cancer associated with markedly limited survival despite effective acute treatment and temporal changes in oncological case mix. Lung cancer was associated with worse prognosis in multivariable analysis. Malignant cardiac tamponade represents a high-risk oncologic emergency requiring interdisciplinary care.
PMID:42206566 | DOI:10.33963/v.phj.112912